Repeated injections of intradetrusor onabotulinumtoxinA as adjunctive treatment of children with neurogenic bladder

Sager, Cristian; Burek, Carol; Bortagaray, Juan I.; Corbetta, Juan Pablo; Weller, Santiago; Durán, Víctor; López, Juan Carlos

doi:10.1007/s00383-013-3365-x

Cited by 18 publications

(10 citation statements)

References 16 publications

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“…[18,21,27,[33][34][35][36][37][38][39][40][41] Reports on the efficacy of BTX in treatment of neurogenic urinary bladder in children have been far less frequent. [19,[43][44][45] In urology, the Botulinum toxin has been used mainly to inject detrusor muscles in order to decrease intravesical pressure in the storage phase, but it has also been applied to sphincters to abolish detrusor-sphincters dyscoordination in the voiding phase. Efficacy of injections to the detrusor has been noted in 60-80% of patients.…”

Section: Resultsmentioning

confidence: 99%

“…So in our study, in children, respectively 10-30 units/kg body weight abobotulinum or 2,5-10 units /kg body weight of onabotulinum were used. [33][34][35][36][37][40][41][42][43][44][45][46][47][48][49][50] Estimating the optimal dosage both in children and adolescents is still discussed. Some authors show, both for abobotulinum or onabotulinum, no clear dose-related effect with the observation indicating that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo.…”

Section: Resultsmentioning

confidence: 99%

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The endoscopic Botulinum toxin-A injections in equally efficient in the treatment of neurogenic bladder dysfunctions in children in different age groups. Single centre experience after more than 550 procedures.

Kroll¹,

Gajewska²,

Kasprowicz³

et al. 2018

Preprint

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The aim of this study was to evaluate the usefulness of cystoscopic injection of Botulinum-A toxin (BTX) in the detrusor wall in the treatment of children with decreased bladder capacity due to neurogenic bladder. The prospective, randomized non placebo controlled trial is conducted in our institution since year 2006 with the approval of the local Ethics Committee. 556 cystoscopic injections of BTX were performed in 141 children with neurogenic bladder in age 1 to 18 years. In all cases decreased bladder capacity and bladder overactivity with urine incontinence were estimated. The pre-and post-treatment evaluations included determination of urinary continence status, bladder function in frequency/volume chart of catheterized urine and in urodynamic studies. Parameters measured in urodynamic investigations included maximal cystometric capacity, detrusor reflex volume, maximal detrusor pressure. Parameters were analyzed before the cystoscopy and during the follow-up examinations in 5 age groups. Values of all measured parameters improved significantly and equally after therapy in every from 5 age groups. The results obtained from the study confirmed that endoscopic administration of BTX improves function of urinary bladder in children with neurogenic bladder, and the method represents an alternative approach to conservative treatment and surgical augmentation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The endoscopic Botulinum toxin-A injections in equally efficient in the treatment of neurogenic bladder dysfunctions in children in different age groups. Single centre experience after more than 550 procedures.

Kroll¹,

Gajewska²,

Kasprowicz³

et al. 2018

Preprint

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show abstract

“…[68][69][70] Children tolerate multiple injections and effects last for 6-9 months, much longer than when botulinum toxin is injected into skeletal muscle. 69,[71][72][73][74] Application drawbacks specific to pediatric patients relate to the requirement of general anesthesia for the procedure, but otherwise, few side effects are reported. 75 A few small case series evaluated intravesical instillation of botulinum toxin without general anesthesia and reported good clinical results, but participants also experienced adverse events of urinary retention, injection site pain, UTIs, and hematuria.…”

Section: Future Directionsmentioning

confidence: 99%

Medical Management of Neurogenic Bladder for Children and Adults: A Review

Lucas

2019

Topics in Spinal Cord Injury Rehabilitation

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Neurogenic bladder is a chronic condition affecting patients of all ages with significant medical and quality of life implications. Goals of treatment consist of protection of the upper urinary tract and promotion of reliable urinary continence. Successful management involves medications and most often bladder drainage via clean intermittent catheterization. This article reviews current literature on medical management to achieve goals of treatment.

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“…In other studies, 50 to 100% of patients were dry at 3-6 months after the BTX injection. [34,37,59,72,78]…”

Section: Continencementioning

confidence: 99%

The Current Role of Botox in a Pediatric Neurogenic Bladder Condition

Kroll

2019

Curr Bladder Dysfunct Rep

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Purpose of Review The neurogenic bladder is a medical term that describes a variety of bladder and sphincter dysfunctions. There are two major dangerous functional problems in a child with neurogenic bladder: high intravesical pressure in the storage phase and high pressure during urination. Two basic goals for urologic treatment in those children are protection of urinary tract from complications and improvement of continence in older children. This review focuses on the current role of botulinum toxin treatment in children with neurogenic bladder. Recent Findings At the beginning, treatment in this group of children is conservative. Oral anticholinergic therapy is aimed at decreasing bladder pressures during the storage phase. Clean intermittent catheterization enables bladder emptying if voiding is insufficient. Nevertheless, in a number of children such an approach fails, in some patients, troublesome side effects occur. In cases when standard therapy provides no improvement or if complications develop on the proper conservative treatment, surgical procedures are suggested. Operations are aimed at the surgical enlargement of bladder capacity. There are some reports on the efficacy of cystoscopic detrusor botulinum toxin injections in the treatment of neurogenic bladder in children. Summary Cystoscopic administration of botulinum toxin represents an alternative method of treatment to surgery for children with neurogenic bladder and could be considered an alternative to oral anticholinergic therapy.

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Repeated injections of intradetrusor onabotulinumtoxinA as adjunctive treatment of children with neurogenic bladder

Abstract: After treatment with onabotulinumtoxinA, urinary continence achieved was 50-77 %. There were favorable changes in urodynamic variables, but they were insufficient. Detrusor overactivity was attenuated, but did not disappear completely.

Cited by 18 publications

References 16 publications

The endoscopic Botulinum toxin-A injections in equally efficient in the treatment of neurogenic bladder dysfunctions in children in different age groups. Single centre experience after more than 550 procedures.

The endoscopic Botulinum toxin-A injections in equally efficient in the treatment of neurogenic bladder dysfunctions in children in different age groups. Single centre experience after more than 550 procedures.

Medical Management of Neurogenic Bladder for Children and Adults: A Review

The Current Role of Botox in a Pediatric Neurogenic Bladder Condition

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